Posted: September 8th, 2015

CASE STUDY : Sebastian

Please place your responses under the following questions in your management plan:
Q1. What physical health considerations should be undertaken prior to giving this medication to the consumer?
Q2. Provide rationales for the use of this medication in this consumer.
Q3. What are the side effects / adverse effects of this medication? Indicate the management strategies that would be used to deal with these effects?
Q4. Discuss the relationship between medication management and recovery principles in mental health.

CASE STUDY : Sebastian

Sebastian is a 23-year-old man who currently lives at home with his parents. Sebastian has a 5-year history of smoking marijuana with his schoolmates. He has had multiple admissions to the local acute psychiatric unit. On his current admission, he was responding to a female auditory hallucination telling him that his neighbour was going to kill him. Sebastian has hardly slept for at least 3/52 prior to this admission, and he has been carrying a knife on his person to protect himself. Sebastian was agitated on admission however; his behaviour became settled quite quickly as he felt safe in the unit. His treating team including his case manager in the community have made the decision to commence Sebastian on RISPERDAL® CONSTA® (risperidone) 75 mg IMI fortnightly. He was discharged home to the care of his parents.
Family History:
Sebastian lives with both of his parents who are very supportive. They both work full time. Sebastian has a younger sister Sally who is 16 and currently completing Year 11.

Medical History:
Sebastian is fit and healthy.
Sebastian has been diagnosed with drug induced psychosis and is currently being managed on an antipsychotic medication RISPERDAL® _CONSTA® _(_risperidone) 75 mg IMI, fortnightly.

Current Mental State Examination

Appearance & Behaviour:
– Healthy weight.
– Height 172cm
– No distinguishing features ( e.g. no scars)
– Attends to personal hygiene
– Guarded at times with some questions
– Easy to establish rapport
– Poor eye contact when irritable
Cognition:
– Orientated to time, place and person
– Short term memory impaired, unable to recall when he last slept

Mood:
– Anxious mood, particularly when preoccupied with neighbour

Affect:
– Restricted affect

Speech:
– Fluent speech
– Clear and concise in communication
– Rate and flow of speech normal

Form of thought:
– Nil formal thought disorder

Content of thought:
– Paranoid towards neighbour, hence feels unsafe in community
– Denies any suicidal and homicidal thoughts

Perception:
– Experiences female auditory hallucination

Insight:
– Limited insight into his illness.
– Constantly questions the need to take his medication

Judgement:
– Poor judgement

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